Автор: Джафарова Саимат Назировна
Должность: преподаватель английского языка
Учебное заведение: ГБПОУ РД "Дербентский медицинский колледж им. Г.А. Илизарова"
Населённый пункт: г.Дербент
Наименование материала: Методическое пособие
Тема: "Practical studies in therapy"
Раздел: среднее профессиональное
МИНИСТЕРСТВО ЗДРАВООХРАНЕНИЯ РД
ГОСУДАРСТВЕННОЕ БЮДЖЕТНОЕ ПРОФЕССИОНАЛЬНОЕ
ОБРАЗОВАТЕЛЬНОЕ УЧРЕЖДЕНИЕ РЕСПУБЛИКИ ДАГЕСТАН
«ДЕРБЕНТСКИЙ МЕДИЦИНСКИЙ КОЛЛЕДЖ
им. Г. А. ИЛИЗАРОВА»
Учебное пособие
для студентов медицинских
колледжей
“Practical studies in therapy”
г. Дербент
Рекомендовано к изданию заседанием цикловой комиссии
гуманитарных дисциплин ГБПОУ РД «Дербентский медицинский
колледж имени Г.А. Илизарова»
Гамзатова Светлана Абдурашидовна – директор ГБПОУ РД
«Дербентский медицинский колледж имени Г.А. Илизарова», к.э.н., заслуженный
врач РД.
Разработчик:
Джафарова Саимат Назировна – преподаватель английского языка
высшей квалификационной категории ГБПОУ РД «Дербентский медицинский
колледж имени Г.А. Илизарова».
Рецензент: Марина Кадировна Меджидова, кандидат филологических наук,
методист, преподаватель иностранных языков ГБПОУ РД «Дербентский медицинский
колледж им. Г. А. Илизарова»
Данное учебно-методическое пособие «Practical studies in therapy» предназначено
для использования на учебных занятиях по дисциплине «Иностранный (английский)
язык» для студентов медицинских колледжей по специальностям 31.02.01. «Лечебное
дело»,
31.02.02.
«Акушерское
дело»,
34.02.01.
«Сестринское
дело»,
31.02.03.
«Лабораторная диагностика» при изучении темы «Practical
studies
in
therapy» под
руководством преподавателя, а также оказание помощи студентам при самостоятельной
работе с текстовым материалом, необходимым для совершенствования навыков и умений
чтения адаптированной и аутентичной медицинской литературы по теме «Practical studies
in therapy»
Пособие построено в соответствии с программами специальностей и включает
тексты, лексический и грамматический материал.
2
Введение
Учебно-методическое
пособие
«PRACTICAL
STUDIES
IN
THERAPY»
подготовлено в соответствии с требованиями ФГОС СПО для специальностей: 34.02.01.
«Cестринское дело»; 31.02.01. «Лечебное дело»; 31.02.02. «Акушерское дело»; 31.02.03.
«Лабораторная диагностика» по дисциплине «Иностранный язык» (английский).
Цель Пособия – оказание помощи студентам при самостоятельной работе с
текстовым материалом, необходимым для совершенствования навыков и умений чтения
адаптированной и аутентичной литературы, и ведения беседы на английском языке.
Сформировать у студентов умения использовать английский язык как средство
профессионального общения – это задача, которую помогает решить данное пособие.
Предлагаемое пособие содержит тексты, заимствованные из современной
английской и американской литературы, обработанные и адаптированные для данного
контингента обучающихся.
Пособие построено в соответствии с программами специальностей. В пособии
представлены тексты с тематическими заданиями.
Для работы с текстом предлагаются задания: на чтение, перевод, нахождение
эквивалентов лексики в текстовом материале на английском и русском языках и
формирование относительно самостоятельных высказываний, а также ответы на вопросы,
упражнения по грамматике.
Учебное пособие позволяет преподавателю организовать самостоятельную и
творческую деятельность студентов, направленную на решение профессионально важных
проблем, и реализует принципы продуктивного подхода в обучении с целью повышения
качества подготовки специалистов в рамках изучения дисциплины «Английский язык».
3
СОДЕРЖАНИЕ
Practical studies in therapy…………………………………………………………………….....5
Functions of a nurse……………………………………………………………………………...7
Fainting…………………………………………………………………………………………..8
Methods of examination…………………………………………………………………….…...9
Case report……………………………………………………………………………………...14
Nursing the patients with respiratory diseases……………………………………………….....17
Educational material………………………………………………………………………….....19
Blood pressure, procedure of its taken……………………………………………………….....24
Practical skills………………………………………………………………………………..…26
The basic symptoms of cardiovascular diseases…………………………………………….….27
Hospital…………………………………………………………………………………………30
Policlinics……………………………………………….............................................................32
Литература………………………………………………………………………..……………35
4
Text
PRACTICAL STUDIES IN THERAPY
George and his fellow student Nick, who had recently recovered from his illness, came to the
therapeutic department of the clinic in Svoboda Street to attend the first practical studies in
Therapy.
During the first practical studies the students acquainted themselves with the work of the
reception ward. There a nurse on duty was receiving those patients who had to be hospitalized.
They had already received the direction from the polyclinic. The nurse on duty was filling in
patient`s case histories. There she was recording the following data: their name, age, place of
employment, occupation. address and the initial diagnosis made by a district doctor
That day the first patient admitted to the in-patient department was Comrade Belov He was a
railway worker, 52 years of age, with a bad heart attack. The onset of the disease had been
sudden and severe. He had already been confined to bed for three days. He was very pale and
weak. It was clear that he was suffering from some serious heart impairment.
The students saw the patient be undressed and laid down on a stretcher. The students also saw
other patients with different diseases of inner organs. The doctor on duty examined them and
gave his instructions to which wards the patients had to be directed.
The students and the assistant doctor went to the in-patient department after their work in the
reception ward. Here they acquainted themselves with the daily regime of the clinic. They were
shown the wards, the X-ray rooms, the laboratories and the procedure room. They could see the
work of the nurses on duty, who were taking the patients temperature, giving the injections,
cupping them, applying mustard plasters and giving medicine.
The same day the students acquainted themselves with the main rules of carrying on a
physical examination and making a family history by questioning a patient thoroughly.
In the following practical class the students learned the methods of examining a patient.
Those methods were: questioning a patient, external examination, percussion, auscultation,
palpation, taking blood pressure, laboratory examination, taking electrocardiograms, etc.
During their practical studies the students saw the doctors make their daily rounds, examine
the patients, who were in the hospital and prescribe them different medicines.
The students learned that doctors in charge made their daily rounds of the wards in the
morning. Besides doctors on duty made the daily rounds of the wards together with other doctors
on definite days.
During their work at the clinic the students remembered well patient Kasakov. His
condition was very poor. The students were allowed to examine this patient, as they had already
5
acquainted themselves with the methods of examination. They questioned the patient and found
out that he had a severe pain in the heart and substernal area. The pain radiated to the left arm
and shoulder. The patient was pale, and his lips were cyanotic. He suffered from breathlessness.
The pain and breathlessness increased on the slightest physical exertion. The students determined
that the borders of his heart were dilated, heart sounds were dull, the pulse was irregular at times.
They also examined other inner organs and found out that it was necessary to take the
electrocardiogram, to make the analyses of blood and urine. Having got all the subjective and
objective findings the students made the initial diagnosis of angina pectoris by themselves. The
assistant doctor confirmed their diagnosis.
The doctor in charge administered the patient a bed regime, proper treatment consisting of
injections, powders, mixtures and diet which the patient had to follow strictly.
During the course of treatment the patient`s condition, as the students could also observe,
gradually became much better regarding all the subjective and objective data. For
Example, the pain in the heart decreased, breathlessness and weakness subsided, heart sounds
became clearer, heart borders and electrocardiogram findings became better. The patient became
more cheerful and alert. The whole course of treatment produced a marked effect on the patient.
He was discharged from the hospital completely cured having stayed there 35 days.
The students understood that a good bedside manner and dealing with the patients
carefully were of great importance. There was no doubt that such an attitude to the patients had
helped much in their recovery.
The duty of the doctor is to treat the patient not only with different remedies, but with a kind
word and hearty attitude.
Words:
1. Therapy
2. A ward
3. Heart attack
4. Procedure
5. Percussion
6. Auscultation
7. A doctor in charge
8. Cyanotic
9. Breathlessness
10. To confirm
6
11. To discharge
Ex.1. Translate.
1. улучшились границы сердца; 2.хороший подход (врача) к больным;
3.одышка и слабость прекратились; 4.лечащий врач назначил больному постельный
режим; 5.было необходимо снять электрокардиограмму; 6.обход палат; 7.пульс временами
был неправильным; 9.место работы; 10.губы у него были синюшны; 11.тоны сердца были
глухие; 12.границы сердца были расширены; 13.осмотр больного, наружный осмотр,
выстукивание, выслушивание.
Ex.2. Put in articles where required:
1. … doctor Belova made … diagnosis of … angina pectoris. 2. Yesterday … doctor
discharged from … hospital … two patients. 3.There is … patient suffering from bad heart
attack in … Ward 15. 4. … patient Smirnov was told to follow … strict bed regime. 5. …
patient with lobar pneumonia has been confined to … bed for … three weeks. 6…. doctors
record all … data regarding their patients` disease in … case histories. 7. … doctor in
charge asked … patient about … place of … employment. 8. … patient aged 33 had …
serious impairment of … heart. 9. On … physical exertion … patient Boyko did not feel …
bad pain. 10. By … percussion doctor tried to determine if … patient suffered from …
impairment of … heart.
Text
FUNCTIONS OF A NURSE
I am a nurse. I work at a therapeutic hospital. Many doctors and nurses work at the hospital.
Our hospital is very large. Work at the hospital begins at 6 o’clock in the morning. The nurses
begin to take the patients’ temperature at 6 o’clock. They write it down in temperature charts.
Then the nurses give the patients medicines and carry out other prescriptions of the doctors. They
open the windows and air the wards. The sometimes I tell the doctor that the temperature of some
of the patients is high and the doctor prescribes some new medicine or injections. I like my
profession very much. I know that much of the nurse’s work can be learnt by practice. So I am
very attentive and try to observe any changes in a patient’s condition. doctors come at 9 o’clock
in the morning and begin to examine the patients. Each ward nurse tells the doctor about her
7
patients. As I am a ward nurse the doctor asks me about the condition of my patients. Sometimes
I tell him that they are well.
Words:
1.
bed – patient – лежачий больной
2.
sitting patient – сидячий больной
3.
up – patient – ходячий больной
4.
in – patient – стационарный больной
5.
out – patient – амбулаторный больной
Text
FAINTING
The cause
of fainting may be different: strong emotion, want of food, fatigue or pain.
In fainting person loses consciousness. Blood doesn't get to the brain. The face of a person
before fainting gets very pale and sweat appears on his forehead. He feels dizzy and weak. His
breathing is shallow. His pulse is weak and slow.
If you help a person who lost his consciousness:
1.
Lay
the person flat
on his back.
2.
Raise his feet a little.
3.
Loose his dress.
4.
Cover him warmly and open the window.
5.
Sprinkle cold water on his face.
6.
Give the person to breathe in ammonia water.
Words:
1.fainting - обморок
2.
cause - причина; вызывать
3.
emotion - душевное волнение
4.
want of food - голод
5.
fatigue - усталость
6.
lose consciousness - терять сознание
7.
brain - мозг
8.
to feel dizzy - чувствовать головокружение
9.
weak - слабый
8
10. shallow - поверхностный
11. slow - медленный
12. to lay - (laid) положить
13. flat - плоско
14. to loose - зд. ослабить
15. to cover - покрывать
16. to sprinkle - брызгать
17. sweat - пот, испарина
18. ammonia - нашатырный спирт.
Ex.1 Find English equivalents. Найдите английские эквиваленты.
Сильные эмоции; терять сознание; кровь не поступает в мозг; лицо становится бледным;
уложить на спину; поднять ноги; побрызгать водой; ослабить одежду; тепло укрыть.
Ex.2 Find Russian equivalents. Найдите русские эквиваленты.
the cause of fainting; wait of food; the face gets pale; sweat appears; he feels diszy; shallow
breathing; weak pulse; slow pulse
Ex.3 Answer the questions.Ответьте на вопросы.
1.
What may be the cause
of fainting?
2.
What does person lose in fainting?
3.
What appears on his forehead before fainting?
4.
What does person feel?
5.
How can you help a person who lost his consciousness?
Text
Examination of a patient
(The text is told on behalf of a medical student)
Inspection, palpation, percussion, auscultation – the unalterable, everapplicable tetrad. Whatever
part of the patient you examine, whatever disease you suspect, the four motions must be done
through in that order. You look first, then feel; when you have felt you may tap, but not before;
and last of all comes the stethoscope.
They taught us to feel lumps, livers and spleens; how to percuss correctly and understand the
evasive murmurs transmitted through a stethoscope.
9
Diagnosis is simple observation and application of logic in practice.
I began to see how the ward was managed by Sister whom I avoided
like a pile of radium. Every bodily function that could be measured – the
pulse, the amount of urine, the quantity of vomit, the number of baths – was
carefully written down against the patient’s name in the treatment book,
which reduced the twenty or so humans in the ward to a daily row of figures
in her aggressive handwriting.
There were two functions of the physiology in which Sister took special interest. One was
temperature. The temperature charts shone neatly from
the foot of the beds, and each showed a precise horizontal zigzag of different
amplitude. The temperatures were taken by the junior nurses, who used four
or five thermometers. However, the figures were looked upon as unimportant,
Sister always substituted figures of her own if the ones of the patient
did not fit with her idea of what the temperature of the case ought to be.
The other particular concern of the Sister was the patient’s bowels. A nurse was sent round the
ward every evening with a special book to ask how
many times each inmate had performed during the past 24 hours. The number
of occasions was written in a separate square at the foot of the temperature
chart. A nought was regarded by Sister as unpleasant, and more than two
blank days she took as a personal insult. Treatment was simple. One nought
was allowed to pass without punishment, but two automatically meant purgative, three – castor
oil and four – the supreme penalty of an enema.
We rapidly became accustomed to our position of inferiority to everyone of the ward staff. We
did all the medical chars – urine testing, gruel meals
in patients with duodenal ulcers, blood samples and a few simple investigations. For the first few
weeks everything seemed easy. It was only at the end of the third month that I realized how
ignorant I was.
From Doctor in the House by R. Gordon
Notes:
1. Sister – старшая медицинская сестра
2. to perform – зд. иметь стул
3. chars – «черная» работа
4. gruel meals – жидкая овсяная каша
ACTIVE VOCABULARY
10
1. admit smb. to a hospital – госпитализиpoвать
2. ant. out-patient – амбулаторный больной
3. auscultation – выслушивание, аускультация
4. bowels – кишечник; syn. intestine
5. breathlessness – одышка; syn. dyspnea
6. bronchitis – бронхит; chronic bronchitis – хронический бронхит
7. complication – осложнение
8. duodenal ulcer – язва двенадцатиперстной кишки
9. enema – клизма; to give enema – поставить клизму
10. examine – обследовать, осматривать
11. hypertension – гипертония
12. infarction – инфаркт; myocardial infarction – инфаркт миокарда
13. inject – впрыскивать
14. injection – укол, инъекция; syn. shot; to give injections – делать инъекции
15. inmate – стационарный больной; syn. in-patient
16. inspection – наружный осмотр; syn. external examination
17. liver – печень
18. lump – опухоль
19. moan – стон; стонать
20. murmur – шум
21. palpation – пальпация, прощупывание
22. percuss – мед. простукивать
23. physician – врач, терапевт syn. general practitioner (G.P.), therapeutist,
internist
24. purgative – слабительное; syn. laxative
25. severe – сильная (боль), тяжелая (форма болезни)
26. spleen – селезенка
27. syringe – шприц
28. tetrad – группа или набор из четырех предметов; число четыре, четверка
29. ulcer – язва; gastric ulcer – язва желудка
30. urinalysis – анализ мочи; syn. urine test
31. vomit – рвота
32. ward – палата; reception ward – приемное отделение
EXERCISES
11
I. Answer the questions:
1. What are the methods of examining a patient?
2. What were the students taught at the hospital?
3. What were the two physiological functions Sister took special interest in?
4. What did the students do at the hospital?
5. Why do you think Gordon realized how ignorant he was only at the end
of the third month?
II. Find in the text English equivalents to the following words and word
combinations:
наружный осмотр, применяемый во всех случаях, какую бы часть..., не- уловимые
шумы, функция организма, младшие медицинские сестры, со- ответствовать
представлению о чем-нибудь, предмет особого беспокой- ства, персонал палаты,
анализ мочи, анализ крови
III. Find in the text synonyms to the following words and word combinations:
external examination, to percuss, amount, to be especially concerned with
smth., intestines, a zero, urinalysis, a blood test, to understand smth.
IV. Fill in the blanks with suitable words:
bowels, complications, enema, blood, injection, liver, murmur, purgative, severe, spleen,
syringe, to be ill, to be wrong, to diagnose, to feel bad, treatment, urgent, urine, vomiting.
1. You should keep to bed if you … with the flu in order not to have ....
2. I hope that ... will be effective and you’ll be well again in no time.
3. A patient with a perforated ulcer of the stomach needs ... operation.
4. The doctor directed me to a laboratory for ... and ... tests.
5. Examining a patient with a heart trouble the physician heard ... in his heart.
6. In case of constipation a person should be given ... or ....
7. Some organs of the abdominal cavity are: ..., …, ….
8. I can’t come to the Institute today, I ... bad. Something ...with my stomach.
9. A nurse sterilized ... before giving ... to a patient.
10. As a woman had ... pains in her abdomen, nausea and ... the doctor ...
acute appendicitis.
V. Say whether the following statements are right or wrong. Correct
them if they are wrong:
1. Heavy smokers often suffer from chronic bronchitis.
2. In case of acute appendicitis a patient must be given a purgative.
3. At a hospital the inmates’ temperatures are taken once a day.
12
4. The duties of nurses at an out-patient department are to take tempera tures,
give injections and prescribe medicines.
5. At drug-stores all medicines are sold only on a doctor’s prescription.
6. People suffering from asthma usually complain of difficulty in breathing
and high blood pressure.
VI. Translate the following sentences paying attention to the construction
it is ... that, it is ... who:
Сочетания it is... that, it is., which, it is... who могут выделять лю- бой заключенный
между компонентами этого сочетания член предложе- ния, кроме сказуемого.
Предложения такого типа – сложноподчиненные
по форме, но простые по содержанию. Дополнительный акцент на слове
или группе слов (эмфаза) в русском языке передается или словом имен- но, или
порядком слов: то, что выделяется рамочной конструкцией it is...
that, ставится в конец предложения: It is these properties of crystals that are
the most important. Именно эти свойства кристаллов наиболее важны.
Наиболее важны эти свойства кристаллов.
1. It is complications that make the flu a dangerous disease.
2. It was an ambulance that brought the patient to the hospital.
3. It was a woman’s high blood pressure that caused a doctor’s alarm.
4. It is our district doctor who prescribed me these pills.
5. It is at our chemist’s that I bought this medicine.
VII. Discuss the following topics:
1. Your idea of a good doctor.
2. A doctor you know or read about that is a model for you.
3. Your classes in therapy.
VIII. Make up a dialogue between a doctor and a patient with:
a. a heart trouble;
b. gastro-intestinal disease.
IX. Dramatize the following dialogue:
Nick Sokolov felt bad in the morning and his wife phoned a local out-patient
department and called in a doctor. Soon the doctor came. Having washed up his hands he
entered the room where Nick was lying and began questioning him.
Doctor: What’s troubling you?
Nick: I have a splitting headache, it hurts me when I breathe and I have pains
13
in my arms and legs.
Doctor: What is your temperature?
Nick: 38.5° C
Doctor: Do you feel nausea?
Nick: Yes.
Doctor: Please strip to the waist and sit up. I’ll listen to your heart and lungs.
Cough a little. That’ll. Your lungs are clear and there is no murmur in the
heart. Does it hurt when I press your abdomen?
Nick: No, it doesn’t.
Doctor: I think you have influenza. I’ll prescribe you some antibiotic to prevent
complications.
Nick: Perhaps I’ll have penicillin injections, doctor?
Doctor: No, there’s no need in it now. Just lie in bed, keep on a light diet and
drink a lot of tea with lemon. It’s a good remedy. I’ll write out a certificate for
you. What is your place of employment?
Nick: School No. 145. I am a teacher.
Doctor: I’ll come back in a few days. Don’t get up without my permission.
Influenza is a tricky disease.
Nick: Thank you, doctor. Good-bye.
Text
CASE REPORT
Patient's characteristics:
Age 22 height 1.7m Sex: M
Weight:70kg
Main symptoms:
*pain in the right lover quadrant ( sporadic and colicky in nature)
*began in epigastrium 2 days ago
*moved to periumbical region and right lower quadrant
Other symptoms:
fever, vomits(3), anorexia, constipation for two days (no bowel movement). No diarrhea
Past history: none
Family history: none
Toxic habits: none
14
Medications: none
Physical finding:
-patient well oriented as to time, place and person
-well nourished;
-extreme tenderness to palpation mainly over Mc'Burney's point;
-guarding, muscle rigidity, rebound tenderness;
-difference: axillary-rectal temperature;
-bowel sounds, absent
Diagnostic procedures:
urinalysis (-)
CBC:WBC|
sed rate:
Hg and ht: normal
Differential diagnosis:
acute pancreatitis, acute cholecystitis, myocardial infarction, gastroduodenal ulcer, perforation of
an ulcer.
Exercise 1. Translate:
Weight, epigastrium, constipation, well nourished, rebound tenderness, muscle rigidity,
physical finding, sed rate, differential diagnosis, acute pancreatitis, acute cholecystitis,
myocardial infarction, gastroduodenal ulcer.
2.
ТЕСТОВЫЕ
ЗАДАНИЯ
ПО
ПРОВЕРКЕ
ЗНАНИЙ
И
УМЕНИЙ
РАСПОЗНАВАНИЯ И УПОТРЕБЛЕНИЯ ГРАММАТИЧЕСКИХ ЯВЛЕНИЙ
1) Выберите нужную форму глагола: There … a lecture on Chemistry tomorrow.
a)
will be
b)
was
c)
to be
2) Выберите нужную форму глагола: The academic year … of two terms.
a)
consists
b)
to consist
c)
consisted
3) Выберите нужный вспомогательный глагол: What … he … now?
a)
has, done
15
b)
is; doing
c)
will, do
4) Выберите нужный вспомогательный глагол: … he read articles in foreign languages?
a)
did
b)
do
c)
does
5) Выберите нужную форму глагола: She … as a nurse at a hospital.
a)
works
b)
working
c)
to work
6) Выберите нужную форму глагола: Doctors … responsible for the patients’ lives.
a)
to be
b)
is
c)
are
7) Выберите нужную форму глагола: The students … practical classes in Surgery tomorrow.
a)
will have
b)
to have
c)
were having
8) Выберите нужную форму глагола: The skeleton … … of over 200 bones.
a)
compose
b)
is composed
c)
are composed
9) Выберите нужную форму глагола: The pelvis … the lower extremity with the trunk.
a)
connects
b)
connect
c)
is connected
10) Выберите нужный модальный глагол: As my sister is ill, she … stay in bed.
a)
must
b)
may
c)
can
11) Выберите нужную форму глагола: Doctor … his patients in consulting room № 6.
a)
receive
b)
receives
c)
receiving
12) Выберите нужный модальный глагол: Medical students … know Anatomy well.
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a)
must
b)
can
c)
may
13) Выберите нужный вспомогательный глагол: What … you doing now?
a)
is
b)
am
c)
are
14) Выберите нужную форму глагола: … your mother a heart disease?
a)
has
b)
have
c)
do
15) Выберите нужный вспомогательный глагол: … your fellow-student get a stipend?
a)
do
b)
does
c)
is
Text
NURSING THE PATIENTS WITH RESPIRATORY DISEASES
Goals of the class: to get a notion about the main pathological
symptoms and methods of the first premedical aid in the respiratory
diseases; to master skills.
Objective of the class:
-
to
know
the
basis
of
human
physiology
of
the
respiratory
system,
the
main
symptoms
of
respiratory
diseases
and
pathogenesis
of
their
origin, rules of sputum collection, care pecularities of patients with
respiratory diseases, rules of pleurocentesis performance;
- to master the methods of observation of respiration,
oxygenotherapy and safety measures working with oxygen, first
premedical aid for patients with the symptoms of respiratory diseases.
The subject-matter of the class:
1) human physiology of the respiratory system, types of breathing in the norm;
2) the main symptoms of the respiratory diseases and the fundamentals of the general care of
patients in their development.
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Equipment required: tables, stopwatches, oxyge pnillows, nosal catheters, spittoons with a lid,
Petri dishes, ice bags, gauze napkins, 10 ml - syringes with thick pleurocentesal needle, pocket
inhaler, test tubes.
Place: a study room, a ward, an intensive care ward.
Exercise 1. Translate:
Respiratory diseases; to master skills, sputum, pleurocentesis, oxygenotherapy, general care of
patients, development, pnillows, nosal catheters, Petri dishes, ice bags, gauze napkins, thick
pleurocentesal needle, pocket inhaler, test tubes.
II. Modal verbs
1. His boss asked him to make a report. He _______ stay after work today.
a) can b) has to c) could
2. They ______ to finish the work in time.
a) must b) were able c) could
3. I didn’t know anything about it. You _______ me.
a) should have told b) should told c) should be telling
4. You …. a dictionary to translate this text into Russian.
a) should b) would c) need
5. _______ you like to go for a drive this weekend?
a) should b) would c) need
6. George passed the examination. He _______ be very clever.
a) should b) must c) can’t
7. Anna has been working in the garden for 4 hours. She ______ be very tired.
a) can b) should c) must
8. A: I wonder who took my alarm clock.
B: It _____ Julia. She _____ supposed to get up early.
a) might be, is b) could be, is c) must have been, was
9. A: Did you enjoy the concert?
B: It was OK, but I ______ to the theatre.
a) must have gone b) had better go c) would rather have gone
10. When I was a child, I _____ a flashlight to bed with me so that I _____ read comic books
without my parents’ knowing them.
a) used to take, could b) was used to taking, could c) would take, can
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Text
EDUCATIONAL MATERIAL (Respiration)
The respiratory diseases are met more often nowadays. The main function of the respiratory
organs is gas exchange. Besides, respiratory organs participate in metabolism, acid-base
equilibrium, defence reactions, blood circulation, thermoregulation and sound production.
Correct care of patients with respiratory impairment is a guarantee both
of successful treatment of the respiratory diseases and the normal functioning of a human
organism on the whole.
Respiration is a process of oxygen getting into the body and carbon dioxide and water steam
withdrawal. Respiration is regulated by a respiratory centre, which is located in medulla
oblongata. A direct irritant of the respiratory centre is an elevated level of carbonic acid and acid
valences in blood as a whole. Process of gas exchange consists of external and internal (tissue)
respiration. External breathing is a gas exchange between atmospheric and pulmonary air and
between pulmonary air and blood. Basically gas exchange takes place in the alveoli. Gas
exchange is insignificantly (1-2%) performed through skin and digestive tract.
Pulmonary ventilation is realized due to inhalation and exhalation – movements of the chest. A
number of respiratory movements in a healthy man varies from
16 to 20 per minute. Respiration rate depends on age, sex and body
position. Accelerated respiration occurs on physical exertion, nervous
excitement, body temperature rise. Breathing slows down in sleep and
in horizontal position.
Counting of respiratory movements is performed invisibly to a
patient. For this purpose a patient’s hand is taken (as if to feel pulse
rate) and placed to a patient’s chest, but in reality it is done to count
thoracic respiratory motions. Normally respiration is rhythmical and of
medium depth.
There are three distinctive physiological types of breathing:
1. Thoracic type – breathing is basically realized by means of
intercostal muscles contraction. During inhalation the thorax widens. It
is basically met in women.
2. Abdominal type - respiratory motions are basically performed with the help of diaphragm.
During inhalation the abdominal wall is displaced. It’s more often met among men.
3. Mixed type – it’s more often met in elderly people.
The main symptoms of the respiratory diseases
and general care of such patients at their development. Shortness
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of breath (dyspnea)
Dyspnea is a disorder of the frequency, rhythm and depth of respiration. A patient, as a rule,
feels lack of air. Dyspnea can be physiological and pathological. Dyspnea can be of pulmonary,
cardiac, hematogenic, neurogenic and psychogenic origin.
There are the following distinctive types of dyspnea:
a) according to the rate:
- tachypnea – accelerated breathing (over 20 respiratory
movements per minute);
- bradypnea – slow breathing (less than 16 respiratory movements
per minute);
b) according to the phase of breathing:
- inspiratory – inhalation is laboured;
- experatory –exhalation is laboured;
- mixed – both breathing phases are laboured;
c) according to disorders of respiratory rhythm:
- Cheyne-Stokes’s respiration
Characteristic feature is periodicity of respiratory movements, between them there are intervals.
A gradual growth of the respiratory movement depth takes place, its maximum is reached within
5-7 inhalations and is followed by the extinction. It is completed with a next short interval.
During an interval a patient may be disoriented or even lose consciousness. An interval can last
from several seconds to a minute. It is observed in heavy heart failure, drug poisoning, cerebral
circulation disturbance, in coma. It can be observed "in the norm" as well – sometimes at an
early children’s age and in adults in their sleep.
- Biot’s respiration
Uniform rhythmic deep respiratory motions alternate through approximately equal spans with
prolonged respiratory intervals. An interval may last from several seconds to half a minute.
- Grokko’s respiration
Reminds Cheyne-Stokes’s respiration, but instead of an interval a weak superficial breathing
with the following increase of depth is noted.
- Kussmaul respiration
A deep infrequent respiration. It’s accompanied by a loud murmur. It is observed in deep
diabetic coma.
Asphyxia (asthma)
Asthma is a strongly marked dyspnea attack. Depending on the origin, asthma may be bronchial
(due to a bronchial spasm) and cardiac (due to congestion in the pulmonary circulation). In
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dyspnea or hard breathing (asphyxia) a nurse must immediately report her observations to a
physician as to dyspnea character, respiration rate and take measures to relieve patient’s
condition:
- to give a patient an elevated (semi-sedentary) posture,
- to get a patient free from tight clothes and heavy blankets,
- to increase fresh air flow into a ward
- to give a patient a pocket inhaler and instruct to use it in case of doctor’s prescription,
- to perform oxygenotherapy in a case of necessity.
Oxygenotherapy
Oxygenotherapy is the use of oxygen in medicine. Indications: acute or chronic respiratory
insufficiency (cardiac insufficiency as well), accompanied by cyanosis, tachycardia (palpitation),
decrease of oxygen partial pressure in tissues.
The oxygen mixture, containing 50-60% (up to 80%) of oxygen is used for the treatment (pure
oxygen can produce a toxic effect on the human body, depress the respiratory centre). Carbogen
(the mixture, containing 95% of oxygen and 5% of carbon dioxide) is used in carbon monoxides
poisoning. In pulmonary edema, characterized by considerable foamy expectoration, oxygen
mixture is bubbled through anti-foaming agents (50-96% solution of ethyl alcohol or 10%
alcoholic
solution of antifomsilanum silicone compound).
There are the following methods of oxygen supply:
1. Oxygen pillow. It is more frequently used under home conditions, when a patient inhales
oxygen through a tube or a mouthpiece.
2. Nasal catheter. It is used in medical institutions with the use of compressed oxygen cylinders
or centralized supply of oxygen to wards. Catheters are inserted into nasal passages on the depth,
equal to the distance between a wing nostril and an ear lobule.
3. A mask. A mask applied to the face covers a mouth and a nose, it has inspiratory and
expiratory channels. The inspiratory channel tubus is connected with thin rubber respiratory bag,
in which oxygen is accumulated during exhalation, and it is actively sucked in by the lungs
during inspiration. One should remember that oxygen must be moistened (by running through
water in the Bobrov’s apparatus).
4. Hyperbaric oxygenation is a treatment with oxygen in high pressure in a special altitude
chamber.
Exercise 1. Translate:
respiratory impairment, carbon dioxide, oxygen, withdrawal,
medulla oblongata, carbonic acid, gas exchange, pulmonary ventilation, inhalation, exhalation,
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respiratory movements, accelerated respiration, physical exertion, dyspnea, tachypnea,
bradypnea, inspiratory, experatory, Cheyne-Stokes`s respiration, asphyxia.
Ex.. Заполните пробелы соответствующей формой глаголов can, could, may или
might:
1.
They (can/might)____ be away for the weekend but I’m not sure. 2. You
(may/might)____ leave now if you wish. 3. (Could/May)____ you open the window a bit,
please? 4. He (can/could)____ be French, judging by his accent. 5. (May/Can)____ you play the
piano? 6. Listen, please. You (may not/might not)____ speak during this exam. 7. They
(can’t/may not)____ still be out! 8. You (couldn’t/might not)____ smoke on the bus. 9. With
luck, tomorrow (can/could)____ be a sunny day. 10. You (can/might)____ be right but I’m going
back to check anyway.
Text
NURSING THE PATIENTS WITH CARDIOVASCULAR DISEASES
Goal: to get a notion about the basic signs of cardiovascular diseases and methods of the first
pre-medical help in their occurrence; common care of patients with cardiovascular diseases; to
master skills.
Knowledge objectives:
- to know normal parameters of pulse and blood pressure and their values in pathology; basic
signs of cardiovascular diseases and a pathogenesis of their development; characteristic features
of the general care of patients with cardiovascular diseases; measures of the first pre-medical
help in the major signs of cardiovascular diseases; diet peculiarities in cardiovascular diseases.
Skill objectives:
- to develop practical skills: taking the arterial pulse, blood pressure, estimating the water
balance, assistance to a doctor performing transabdominal puncture.
Subject-matter:
1)arterial pulse, techniques of taking, its basic characteristics;
2)blood pressure, techniques of measuring. Concepts of arterial hypertension, hypertensive
crisis, arterial hypotension;
3)the basic signs of cardiovascular diseases and the first premedical help in their appearance;
4)diet in cardiovascular diseases;
5)techniques of a transabdominal puncture (laparocenthesis) and assistance to a doctor.
Equipment required: medical tonometer (sphygmomanometer), a stop watch, balance,
temperature chart, graduated jar.
22
Exercise 1.
Translate:
cardiovascular diseases, characteristic features, diet peculiarities,
transabdominal puncture, hypertensive crisis, arterial hypotension,
First premedical help.
EDUCATIONAL MATERIAL (Cardiovascular diseases)
Cardiovascular diseases such as essential or arterial hypertension
(AH)1 , coronary heart disease (CHD), heart failure (HF) are the most
wide-spread and dangerous diseases now. So, AH is present nearly in each second adult person
(J.N.Belenkov, 2002); lipid disorders underlying CHD, are found in 60% of Russian inhabitants
in efficient age. Thus the amount of cardiovascular diseases annually grows for 4,7% with an
annual accretion approximately in 1 million patients in Russia. Mortality in Russia by 2,5 times
exceeds mortality in the developed countries and it is even called "supermortality", as out of 148
million inhabitants of Russia over 1 million people die annually (900 person for 100000
population), and according to official statistics the population of Russia can cut down by a half in
60 years. Almost 56% from this total mortality are due to cardiovascular mortality, and now the
mortality from AH in the young age has dramatically increased. By the level of mortality from
stroke, this basic complication of AH, Russia occupies the first place in the world. Thus,
cardiovascular diseases threaten to the national safety of Russia. The principal cause of such
prevalence and such mortality from cardiovascular diseases is that despite the intensive
researches of scientists and doctors in the whole world, the reason (etiology) of these diseases
remains uncertain. AH abroad even has synonymic (and the most wide-spread) name in which
uncertainty of its etiology is
emphasized – an essential hypertension. Hippocrate said: «Sublata cousatollitur morbus» -
eliminating a cause, you remove disease. Apparently, this position is also just today. However
despite the uncertainty of the causes, many risk factors are revealed along with some
pathogenetic ways in the development of these diseases. It is possible and it is necessary to
struggle against them actively. At the
same time it is a great challenge to reveal them at an early stage when patients do not have any
complaints and do not go to see a doctor.
By virtue of that an essential hypertension - heterogenous disease with rather clear clinical
pathogenetic variants, essentially differing at the initial stages by mechanisms of development, in
literature instead of the term "essential hypertension" (EH) scientists frequently use «arterial
hypertension» (AH). Actually these terms are synonyms (according to I.E.Chazova, 2004).
That's why an essential hypertension is also named “silent disease”, and even “the silent and
mysterious murderer” in the USA. "Silent" – as there are no complaints, and consequently
23
patients do not go to see a doctor; "mysterious" – as the etiology is unknown; "murderer" – as
quite suddenly there develop potentially lethal complications - a stroke and myocardial
infarction. That's why to search for more perfect methods of prophylaxis, diagnosis and
treatment of cardiovascular diseases is an important task challenging medicine and society as a
whole. Performance of
dispensarisation of the population or screening, i.e. “sieving”, inspections for detection of AH in
various groups of the “organized” and “unorganized” population is very important. Recently the
spectrum of the research methods in cardiology has considerably increased – daily
electrocardiography Holter monitoring, monitoring of blood pressure, echocardiography
(EchoCG), stress
echocardiography, etc. However the comparatively simple, the so-called classical methods of
examination, i.e. feeling the pulse, taking blood pressure are still of great value. They are rather
informative due to the received valuable information concerning the condition of hemodynamics
and a patient as a whole. Taking blood pressure (BP) should be made at patient's visit for a
medical help of any kind, irrespective of the reason of going to a doctor. Therefore for everyone,
who measures BP, it is important to do this obligatory (see below). That is not always done in
routine medical practice and consequently mistakes can be observed
Exercise 1. Translate: essential or arterial hypertension, coronary heart disease, heart failure,
lipid disorders, efficient age, annual accretion, supermortality, cardiovascular mortality, stroke,
national safety of Russia, the intensive researchers of scientists, emphasized, heterogenous
disease, prophylaxis, hemodynamics.
BLOOD PRESSURE, PROCEDURE OF ITS TAKING
Blood pressure is the pressure which is generated in the arterial system during the work of the
heart. Depending on a phase of a cardiac cycle, blood pressure (BP) is named systolic (SBP), i.e.
it arises in arteries after systole of a left ventricle (corresponds to the maximal heaving of pulse
wave), and diastolic blood pressure (DBP) is maintained in arteries during diastole due to their
tone (corresponds to
the fall of pulse wave). The difference between magnitudes of a SBP and DBP is named pulse
pressure (PP). Blood pressure is measured in millimeters of a mercurial pole, shortly in mmHg.
Why is it necessary to know the figures of blood pressure? Blood pressure is one of the major
parameters of functioning of an organism; therefore it is necessary for everyone to know it.
Growth of BP every 10 mmHg increases risk of the development of cardiovascular diseases by
30%. People with elevated BP have strokes (insults) 7 times more often, coronary heart disease 4
times more often, the lesion of the leg's arteries 2 times more often than people with normal BP.
24
BP depends on the magnitude of heart output, total peripheric vascular resistance, frequency of
cardiac contractions, and volume of circulating blood. Taking of blood pressure is the important
method of monitoring the state of hemodynamics both in healthy and ill people. In usual medical
practice standart method of taking blood pressure is an indirect method with the help of
pneumatic cuff of the special device – a sphygmomanometer (Greek “phygmos” - pulse + a
manometer: Greek “manos” - fluid, scarce, diluted tissue; “metron” – measuring, an instrument
for definition of gases or fluid pressure, namely for taking blood pressure). Blood pressure can
be taken by Korotkov method of auscultation (in real practice), and by palpation (i.e. Riva-
Rochchi method). Depending on the construction of a recording part of a sphygmomanometer
the latter are divided into mercurial
sphygmomanometers (the most precise), aneroid (spring) sphygmomanometers (quite often
underestimating BP and electron sphygmomanometers.
The sphygmomanometer consists of hollow cuff with inflatable rubber cavity, rubber bulb
("pear") with the valve and a screw lock, a manometer (mercurial, mechanical or electron) and
rubber tubes.
Blood pressure is measured in volume of raising of a Hydrargyrum (Hg) level or resisting
strength of a spring, which is transferred to the finger, moving on a dial with millimeter
divisions.
The "Gold" standard of BP measuring is direct measuring through the rigid catheter, inserted
interarterially.
The mercurial sphygmomanometer was created by the Italian pediatrist and pathologist Stsipione
Riva-Rochchi in 1896. He offered the device for taking BP, in which ring compression of a
humeral artery with rubber cuff filled with air was used. During more than 100 years of its
creation the device practically had not changed. This device was spread all over the world and
now is called Riva-Rochchi. The sphygmomanometer allows to take BP noninvasively. The
sphygmomanometer Riva-Rochchi could take only systolic BP (releasing a pulse wave after
compression of an artery). The average of two values of BP was recorded: appearing at the
moment of ceasing of pulse wave and then its repeated occurrence. Even then for the first time
Riva-Rochchi described the effect “of a white gown” while taking BP
Exercise 1. Translate: blood pressure, arterial system, cardiac cycle, auscultation, palpation,
hollow cuff, rubber cavity, valve, screw lock, rubber tubes, white gown, ring compression, rigid
catheter, humeral artery, noninvasively, pulse rate, rigid catheter, ring compression, humeral
artery with rubber cuff, to take BP noninvasively, pulse wave, resisting strength of a spring, the
magnitude of heart output, an indirect method with the help of pneumatic cuff of the special
device,
25
People with elevated BP.
PRACTICAL SKILLS
Blood pressure taking
1.To suggest a patient to occupy a comfortable sitting position. The back should be supported by
the backrest of a chair, while the legs should be placed on the floor. Ask a patient to take off a
shirt. If he wears a shirt made of thin tissue with a short sleeve, it may be not taken off, as such
a sleeve does not affect BP taking.
2.BP should be taken on both arms!
3.A patient’s arm should be on a table with the palm upwards, muscles of the arm should be
relaxed, and the middle part of a shoulder should be on the level of the heart (that is on the level
of IV-V intercostal spaces).
4.Pulsation of the humeral artery should be found out by palpation in the middle part of a
shoulder.
5.To check up the condition of a sphygmomanometer’s cuff (if there is some air in a cuff it
should be removed).
6.To arrange the middle of a rubber bulb flated of a cuff exactly over the palpated humeral
artery (in the middle part of the shoulder), to wrap up tightly and fix a cuff around the exposed
arm of a patient.
7.To check up the correctness of the cuff application: between a cuff and the shoulder of a
patient 1 finger should be located, the lower edge of a cuff is placed by 2 cm above the cubital
area (approximately by 2 diametrical fingers), the outlet of a rubber tube is below the cuff
outside the cubital area and does not prevent the artery auscultation.
8.To place a manometer so that the mercury or aneroid disk center is at your eye level (the zero
level of the mercury of sphygmomanometer should be at the cubital area).
9.To define the degree of pressure lifting in a cuff, you should use the following method: pulse
palpation in the radial artery, with simultaneous quick pumping up a cuff approximately up to
70 mmHg and the gradual pressure enlargement by 10 mmHg. To mark pressure at which the
pulse disappears (palpable definition of the systolic pressure level).
10. Palpably define the maximal pulsation point of the humeral artery, located usually above the
cubital area on the humeral internal surface of a shoulder, apply tightly (but not strongly)
phonendoscope membrane to this place.
26
11. Quickly and evenly pump up the air into a cuff until the pressure reaches the systolic BP
level defined preliminary by palpation (see item 8) + 30 mmHg.
12. Open the valve and gradually let out the air from a cuff at the rate of 2 mmHg in a second,
simultaneously listening to the appearance of Korotkov’s sounds and observing the manometer
indices or mercury level.
13. Mark the manometer indices at the first appearance of pulse sounds (phase I – systolic BP)
and at their disappearance (phase V of Korotkov’s sounds – diastolic BP). After the Korotkov’s
sounds are not auscultated, it is necessary to continue the slow decrease of pressure in a cuff by
10 mmHg at least to be convinced, that no sounds are auscultated anymore. After that a cuff is
quickly and completely
decompressed (to dismiss a "release" of rubber tubes by the use of mercury
sphygmomanometer).
14. After BP taking let a patient have a rest not less than for 30
seconds.
Examination of the arterial pulse
1.Pulse is defined in the various arteries – in carotid (along the anterior margin of m.
sternocleidomastoideus, approximately in the middle of its length), femoral, subclavicular,
humeral, and radial (more often).
2.The radial artery is palpated between a styloid process of the radial bone and a tendon of the
internal radial muscle, and a hand of an examinant is placed higher of the radiocarpal joint, so
that a thumb is placed down on the forearm back, and other fingers are put on its anterial
(internal) surface.
3.Having felt an artery, press it to an adjoining bone, so that the pulse wave is felt as dilatation
and collapse of an artery.
4.Pulse on the right and left hands can be unequal, in such cases (to assess the actual heart work)
feeling of the pulse is carried out on the arm where it is better palpated.
5.For definition of the pulse rate the amount of pulse waves is counted for 15 seconds and then it
is multiplied by 4. In case of arrhythmia the counting is performed within a minute.
Exercise 1. Translate: practical skills, cuff application, pulse palpation, radial artery,
simultaneous, gradual pressure, enlargement, systolic pressure, cubital area, maximal palpation,
apply tightly, femoral, subclavicular, styloid process, internal radial muscle, radiocarpal joint,
adjoining bone.
Text
THE BASIC SYMPTOMS OF CARDIOVASCULAR DISEASES.
27
NURSING THE PATIENTS WITH CARDIOVASCULAR DISEASES
Heart pain
Assessing a patient’s complains of heart pain it is necessary to remember, that pains are not
always caused by cardiovascular disease, and can be connected with pleural disease (dry
pleuritis), pathology of the backbone and intercostal nerves (osteochondrosis, intercostal
neuralgia), myositis, hernia of the esophageal hiatus diaphragm, etc.
The chest pains, connected with pathology of the blood circulation system, can be caused by the
diseases of pericardium, aorta, neurotic condition.
Stenocardia attack [Greek “stenosis” - narrowing, “kardia” - heart; synonyms: angina pectoris
(Lat. “ango” - to compress, “pectus” -breast), Geberden disease] is a result of the narrowing of
coronary arteries due to the atherosclerotic process or spastic stricture. Thus there develops a
disharmony between myocardial requirement in oxygen and opportunities of the coronary blood
flow which results in hypoxia of the cardiac muscle, metabolism is disordered in it, and
incompletely
oxygenated metabolic products irritate the sensitive nerve endings in the myocardium, causing a
pain attack.
In a typical case angina pectoris attack is provoked by the physical
or emotional exertion; pains are retrosternal, have a pressing, burning or
compressive character. They irradiate to the left shoulder, arm, the left
half of the neck, the mandible, and last from 1 to 10 minutes and pass
independently at rest, or in 1-3 minutes after the sublingual reception of
a nitroglycerin tablet.
The first aid to a patient in angina pectoris attack consists of maintenance of the complete rest,
sublingual nitroglycerin reception and rarely the application of a mustard plaster on the heart
area. A very serious disease which as a rule complicates a durable non arrested angina pectoris
attack is the myocardial infarction at the basis of which is the necrosis of a cardiac muscle. The
most frequent so-called typical (painful, anginous) variant of myocardial infarction is
characterized by the development of retrosternal severe pains, stopped neither at rest, nor by
nitroglycerin reception which last more than 30 minutes (to several hours). These pains are
accompanied by the feeling of fear, dyspnea, sharp weakness, decreasing of blood pressure, etc.
For such patients urgent
hospitalization is necessary to the intensive care ward supplied with all necessary equipment for
monitoring (automatic constant tracking) of their condition (first of all the cardiovascular system
condition) and carrying out of reanimation actions if necessary. A patient is confined to bed
within the first days; during this period it is necessary to control the changing of patient’s bed-
28
clothes, performance of all hygienic procedures, patient’s feeding, a bedpan or an urinal giving,
etc.
Shortness of breath, cardiac asthma and pulmonary edema Shortness of breath in cardiovascular
diseases is one of the attributes of heart failure. The heart failure is caused by the progressing
decrease of myocardial contracting function, congestion in the pulmonary circulation and liquid
retention in the body. In shortness of breath of the cardiac origin blood is accumulated in the
pulmonary and a patient experiences a painful feeling of lack of air in the physical exertion and
stress at first, and later at rest as far as the disease progresses.
Dyspnea (cardiac asthma) in heart failure is a sudden severe attack of shortness of breath,
accompanied by noisy breathing, more frequently occurred at night (because of the increased
tone of a vagus nerve, which causes a narrowing of coronary vessels). Thus a patient is
compelled to take a sitting position. The cardiac asthma attack develops in sharp decrease of the
contracting ability of the cardiac muscle due to its necrosis (myocardial infarction), inflammation
(severe myocarditis) or overloads (hypertonic crisis, an inadequate exercise).
Pulmonary edema is the most serious manifestation of heart failure, when the liquid part of
blood passes ("transudes") through the vessel walls and accumulates in alveoli. Thus bubbling
respiration and pink foamy expectoration join the symptoms of cardiac asthma mentioned
already.
The first aid in shortness of breath consists in a patient’s rest, giving a patient sitting or semi-
sitting position, taking off tight clothes, fresh air access, nitroglycerin giving (in the absence of
contraindications) or antihypertensive medicine in case of increased BP (according to a doctor’s
prescription).
Cardiac asthma and pulmonary edema need the active aid measures:
1) it is necessary to call a doctor first of all;
2) to give a patient a sitting position;
3) to take a patient's blood pressure;
4) to give a patient nitroglycerin sublingually, if a patient’s systolic pressure is not lower than
100 mmHg;
5) to begin an oxygenotherapy with antifoamer through a mask or a nasal catheter (as an
antifoamer 96% alcohol solution or 10% alcohol solution of antifomsilhan are usually used);
6) it is necessary to aspirate a foamy sputum by an electroaspirator;
7) after giving a patient sitting position, tourniquets are applied on the legs with the purpose of
blood deposition in the systemic circulation and delay of its inflow to lungs. Thus on both legs
15 cm below the inguinal fold tourniquets or rubber tubes, or blood pressure cuffs for tonometer
are applied. Only the veins are pressed, i.e. the arterial pulse below a tourniquet should be kept,
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while the extremities should become cyanochroic, but not acyanotic (pale); the time of
tourniquets application is 15-20 minutes;
8) venous tourniquets should be also applied to the arms. Tourniquet removal should be carried
out successively: first from one arm, after a while – from the other, etc. in a slow regimen;
9) bloodletting (phlebotomy) is carried out to evacuate a part of circulating liquid from the blood
flow and to unload the pulmonary circulation (by a doctor’s prescription);
10) hot foot baths are used;
11) narcotics, diuretics, inhibitors of APF, inhibitors of phosphodiesterase, creatine phosphate,
cardiac glycosides, etc., are introduced intravenously by a doctor’s prescription.
Exercise 1. Translate: complains, heart pain, pleural disease, backbone, intercostal nerves,
myositis, hernia, esophageal hiatus diaphragm, chest pains, circulation system, pericardium,
neurotic condition, stenocardia attack, angina pectoris, atherosclerotic process, hypoxia, cardiac
muscle, emotional exertion, retrosternal, compressive character, mandible, miocardial infarction,
sharp weakness, heart failure, bubbling respiration.
Text
HOSPITAL
After medical check-up (examination) doctors administer different procedures to the
patients. They order electrocardiograms to be taken of some patients. Other patients are to
undergo lab. tests. Some patients are administered a bed regimen, some are recommended
(allowed) to have a walk, some are to follow a special diet to relieve pain in the stomach or to
prevent stomach troubles.
As a rule the doctors treat their patients carefully that helps sick people to get better.
As soon as the patient is admitted to the in-patient department the ward doctor fills-in the
patient’s case report (case history, case record, in-patient'’ card, in-patient’s chart – история
болезни). It must include the information about the patient’s parents – if they alive or dead.
The doctor must know what caused the death and at what age the parents died. It is
necessary for a doctor to know if anybody in the family has ever been ill with tuberculosis or has
had any mental or emotional impairments. This information composes the family history
(семейный, наследственный анамнез).
The patient’s medical history (case report, case record, medical in-patient card, chart) must
include the information about diseases the patient had both as a child and as an adult. The doctor
must know if a patient had an operation or a trauma. These finding compose the past history (PH
past medical history, life history – жизненный анамнез). The patient’s blood group and his
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sensitivity to antibiotics must be determined. The doctor writes down the obtained information
in the case report.
The attending doctor must know the symptoms and complaints of patients as well as how
long the people have had these complaints.
The history of present illness makes a part of a case history. The history of present illness
contains a lot of findings, i.e. information of the patient on his admission, the results of
laboratory tests and X-ray examination, the course of the disease with any changes in symptoms
and condition, the exact doses of the administered (prescribed) medicines, the effects of
treatment.
The case history must always be written, very accurately and have exact and complete
information.
Words.
1.
case history (case report, in-patient card, in-patient chart, case record) – история болезни;
2.
to cause the death – вызывать смерть;
3.
mental
or
emotional
impairments
–
душевные
или
эмоциональные
нарушения
(повреждения);
4.
trauma – травма;
5.
past history (PH, past medical history, life history) – жизненный анамнез;
6.
blood group – группа крови;
7.
sensitivity – чувствительность;
8.
the history of present illness – история настоящего заболевания.
Ex.1 Find Russian equivalents. Найдите русские эквиваленты:
To admit to the hospital, a reception ward, a doctor on duty, a nurse on duty, to fill-in a case
report, initial diagnosis, to give intravenous injections, to give intramuscular injections, stomach
troubles, bed regimen, accurately, exact, complete information, is admitted to the in-patient
department, fills-in, the patient'’ case report, must include, if they alive or not, to cause the death,
has ever been ill with, tuberculosis, any mental or emotional impairments, to compose, medical
history must include, to have an operation or a trauma, past history, sensitivity, the patient'’
blood group, the obtained information, symptoms and complaints.
Ex.2 Find English equivalents. Найдите английские эквиваленты.
история
болезни
(дать
синонимы);
точный
полный;
верный
(правильный);
при
поступлении в больницу; результаты лабораторного обследования; течение болезни;
изменения в симптомах и состоянии больного; дозы выписанного лекарства; воздействие
лечения; очень точно; верная и полная информация
31
Ex.3. Заполните пробелы личными местоимениями в объектном падеже: 1. My friend
Tom lives in London. This is a parcel from (него) ____ . 2. I’m sorry, I can’t tell (тебе) ____
what happened. 3. The children are hungry. Give (им) ____ an apple. 4. We are thirsty. Can you
give (нам) ____ some juice? 5. Jack is in the garden. Bring (ему) ____ his book. 6. Ann and
Paul can’t do their homework. Can you help (им) ____ ? 7. I can’t help (вам) ____ tomorrow. I
must visit my aunt. 8. These clothes are for poor children. Can you bring (их) ____ to the Red
Cross?
Text
POLICLINICS
There are many polyclinics in our country. Doctors of different specialties: therapeutists,
neurologists, surgeons, dentists, oculists, psychiatrists, urologists and nurses wore there. There
are many different laboratories, x-ray and procedure rooms, consulting and waiting rooms in our
polyclinics.
When a patient comes to the polyclinics he goes to the registry first. A registering clerk on
duty asks his name, address, age, occupation and writes it down in the patient’s card.
Doctors examine their patients in their consulting rooms. During the medical examination
doctors question their patients thoroughly, listen to their heart and lungs, feel their pulse and take
their blood pressure, palpate, auscultate and percuss them, make the diagnosis, fill in their cards
and prescribe them a special treatment.
During the physical examination doctors use such methods as palpation, percussion,
auscultation, questioning a patient, feeling his pulse, taking electrocardiograms, etc.
At the end of the physical examination doctors make a diagnosis, prescribe the necessary
medicine and treatment if it is necessary.
Our doctors treat patients not only with the help of different mixtures, powders, injections,
but they always use a good bedside manner and deal with patients very carefully.
The duty of the doctor is to treat a patient not only with different remedies but with a kind
word and hearty attitude.
Words.
1.
case history (case report, in-patient card, in-patient chart, case record) – история болезни;
2.
to cause the death – вызывать смерть;
3.
mental
or
emotional
impairments
–
душевные
или
эмоциональные
нарушения
(повреждения);
32
4.
trauma – травма;
5.
past history (PH, past medical history, life history) – жизненный анамнез;
6.
blood group – группа крови;
7.
sensitivity – чувствительность;
8.
the history of present illness – история настоящего заболевания.
Ex.1 Find Russian equivalents. Найдите русские эквиваленты:
To admit to the hospital, a reception ward, a doctor on duty, a nurse on duty, to fill-in a case
report, initial diagnosis, to give intravenous injections, to give intramuscular injections, stomach
troubles, bed regimen, accurately, exact, complete information, is admitted to the in-patient
department, fills-in, the patient'’ case report, must include, if they alive or not, to cause the death,
has ever been ill with, tuberculosis, any mental or emotional impairments, to compose, medical
history, must include, to have an operation or a trauma, past history, sensitivity, the patient'’
blood group, the obtained information, symptoms and complaints.
Ex.2 Find English equivalents. Найдите английские эквиваленты.
история
болезни
(дать
синонимы);
точный
полный;
верный
(правильный);
при
поступлении в больницу; результаты лабораторного обследования; течение болезни;
изменения в симптомах и состоянии больного; дозы выписанного лекарства; воздействие
лечения; очень точно; верная и полная информация
Ex.3. Заполните пробелы личными местоимениями в объектном падеже: 1. My friend
Tom lives in London. This is a parcel from (него) ____ . 2. I’m sorry, I can’t tell (тебе) ____
what happened. 3. The children are hungry. Give (им) ____ an apple. 4. We are thirsty. Can you
give (нам) ____ some juice? 5. Jack is in the garden. Bring (ему) ____ his book. 6. Ann and
Paul can’t do their homework. Can you help (им) ____ ? 7. I can’t help (вам) ____ tomorrow. I
must visit my aunt. 8. These clothes are for poor children. Can you bring (их) ____ to the Red
Cross?
33
Литература
1.Козырева Л.Г. Английский язык для медицинских колледжей и училищ. – Ростов-на-
Дону: Феникс, 2020. – 329 с.
2.Raymond Murphy. English Grammar in Use. Cambridge University Press, 2019. – 380 c.
Кролик Н.И. Английский язык для студентов – медиков: Учебное пособие для вузов. - М.:
ООО Изд-во Астрель, 2003. – 128 с.
3.Маслова А.М. Учебник английского языка для медицинских вузов./Маслова А.М.,
Вайнштейн З.И., Плебейская Л.С.- М.: Высшая школа, 2002. – 336 с.
4.Муравейская М.С., Орлова Л.К. Английский язык для медиков. Учебное пособие для
студентов, аспирантов, врачей и научных сотрудников. М: «Флинта», «Наука», 2002.–384
с.
5.Мухина В.В. Английский язык для медицинских училищ. - М.: Высшая школа, 2002. -
141 с.
6.Тылкина С.А., Темчина Н.А. Пособие по английскому языку для медицинских училищ. -
М.: АНМИ, 2002. – 158 с.
7.Щедрина Т.П. Английский язык в медицине. - М.: Высшая школа, 2004. – 207 с.
8. В. А. Державина. Английский язык. Полная грамматика. Издательство «АСТ», Москва,
2018. – 320 с.
9.Интернет-ресурсы:
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